Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT

Kaitlin M. Christopherson; Jillian R. Gunther; Penny Fang; Stacy L. Peterson; Karen E. Roach; Pei Fong Wong; Dragan Mirkovic; Tze Yee Lim; He Wang; Xin A. Wang; Congjun Wang; John Garcia; Bouthaina S. Dabaja; Chelsea C. Pinnix

doi:10.1016/j.ctro.2020.05.013

Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT

Kaitlin M. Christopherson, Jillian R. Gunther, Penny Fang, Stacy L. Peterson, Karen E. Roach, Pei Fong Wong, Dragan Mirkovic, Tze Yee Lim, He Wang, Xin A. Wang, Congjun Wang, John Garcia, Bouthaina S. Dabaja, Chelsea C. Pinnix

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

We hypothesized that deep inspiration breath-hold (DIBH) and computed-tomography image-guided radiotherapy (CT-IGRT) may be beneficial to decrease dose to organs at risk (OARs), when treating the stomach with radiotherapy for lymphoma. We compared dosimetric parameters of OARs from plans generated using free-breathing (FB) versus DIBH for 10 patients with non-Hodgkin lymphoma involving the stomach treated with involved site radiotherapy. All patients had 4DCT and DIBH scans. Planning was performed with intensity modulated radiotherapy (IMRT) to 30.6 Gy in 17 fractions. Differences in target volume and dosimetric parameters were assessed using a paired two-sided t-test. All heart and left ventricle parameters including mean dose, V30, V20, V10, and V5 were statistically significantly lower with DIBH. For IMRT-FB plans the average mean heart dose was 4.9 Gy compared to 2.6 Gy for the IMRT-DIBH group (p < 0.001). There was a statistically significant decrease in right kidney dose with DIBH. For lymphoma patients treated to the stomach with IMRT, DIBH provides superior OAR sparing compared to FB-based planning, most notably reducing dose to the heart and left ventricle. This strategy could be considered when treating other gastric malignancies.

Original language	English (US)
Pages (from-to)	79-82
Number of pages	4
Journal	Clinical and Translational Radiation Oncology
Volume	24
DOIs	https://doi.org/10.1016/j.ctro.2020.05.013
State	Published - Sep 2020

Keywords

Deep inspiration breath-hold
Gastric lymphoma
Heart dose

ASJC Scopus subject areas

Oncology
Radiology Nuclear Medicine and imaging

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10.1016/j.ctro.2020.05.013

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Christopherson, K. M., Gunther, J. R., Fang, P., Peterson, S. L., Roach, K. E., Wong, P. F., Mirkovic, D., Lim, T. Y., Wang, H., Wang, X. A., Wang, C., Garcia, J., Dabaja, B. S., & Pinnix, C. C. (2020). Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT. Clinical and Translational Radiation Oncology, 24, 79-82. https://doi.org/10.1016/j.ctro.2020.05.013

Christopherson, KM, Gunther, JR , Fang, P, Peterson, SL, Roach, KE, Wong, PF , Mirkovic, D , Lim, TY , Wang, H , Wang, XA , Wang, C, Garcia, J, Dabaja, BS & Pinnix, CC 2020, 'Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT', Clinical and Translational Radiation Oncology, vol. 24, pp. 79-82. https://doi.org/10.1016/j.ctro.2020.05.013

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title = "Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT",

abstract = "We hypothesized that deep inspiration breath-hold (DIBH) and computed-tomography image-guided radiotherapy (CT-IGRT) may be beneficial to decrease dose to organs at risk (OARs), when treating the stomach with radiotherapy for lymphoma. We compared dosimetric parameters of OARs from plans generated using free-breathing (FB) versus DIBH for 10 patients with non-Hodgkin lymphoma involving the stomach treated with involved site radiotherapy. All patients had 4DCT and DIBH scans. Planning was performed with intensity modulated radiotherapy (IMRT) to 30.6 Gy in 17 fractions. Differences in target volume and dosimetric parameters were assessed using a paired two-sided t-test. All heart and left ventricle parameters including mean dose, V30, V20, V10, and V5 were statistically significantly lower with DIBH. For IMRT-FB plans the average mean heart dose was 4.9 Gy compared to 2.6 Gy for the IMRT-DIBH group (p < 0.001). There was a statistically significant decrease in right kidney dose with DIBH. For lymphoma patients treated to the stomach with IMRT, DIBH provides superior OAR sparing compared to FB-based planning, most notably reducing dose to the heart and left ventricle. This strategy could be considered when treating other gastric malignancies.",

keywords = "Deep inspiration breath-hold, Gastric lymphoma, Heart dose",

author = "Christopherson, {Kaitlin M.} and Gunther, {Jillian R.} and Penny Fang and Peterson, {Stacy L.} and Roach, {Karen E.} and Wong, {Pei Fong} and Dragan Mirkovic and Lim, {Tze Yee} and He Wang and Wang, {Xin A.} and Congjun Wang and John Garcia and Dabaja, {Bouthaina S.} and Pinnix, {Chelsea C.}",

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year = "2020",

month = sep,

doi = "10.1016/j.ctro.2020.05.013",

language = "English (US)",

volume = "24",

pages = "79--82",

journal = "Clinical and Translational Radiation Oncology",

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T1 - Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT

AU - Christopherson, Kaitlin M.

AU - Gunther, Jillian R.

AU - Fang, Penny

AU - Peterson, Stacy L.

AU - Roach, Karen E.

AU - Wong, Pei Fong

AU - Mirkovic, Dragan

AU - Lim, Tze Yee

AU - Wang, He

AU - Wang, Xin A.

AU - Wang, Congjun

AU - Garcia, John

AU - Dabaja, Bouthaina S.

AU - Pinnix, Chelsea C.

PY - 2020/9

Y1 - 2020/9

N2 - We hypothesized that deep inspiration breath-hold (DIBH) and computed-tomography image-guided radiotherapy (CT-IGRT) may be beneficial to decrease dose to organs at risk (OARs), when treating the stomach with radiotherapy for lymphoma. We compared dosimetric parameters of OARs from plans generated using free-breathing (FB) versus DIBH for 10 patients with non-Hodgkin lymphoma involving the stomach treated with involved site radiotherapy. All patients had 4DCT and DIBH scans. Planning was performed with intensity modulated radiotherapy (IMRT) to 30.6 Gy in 17 fractions. Differences in target volume and dosimetric parameters were assessed using a paired two-sided t-test. All heart and left ventricle parameters including mean dose, V30, V20, V10, and V5 were statistically significantly lower with DIBH. For IMRT-FB plans the average mean heart dose was 4.9 Gy compared to 2.6 Gy for the IMRT-DIBH group (p < 0.001). There was a statistically significant decrease in right kidney dose with DIBH. For lymphoma patients treated to the stomach with IMRT, DIBH provides superior OAR sparing compared to FB-based planning, most notably reducing dose to the heart and left ventricle. This strategy could be considered when treating other gastric malignancies.

AB - We hypothesized that deep inspiration breath-hold (DIBH) and computed-tomography image-guided radiotherapy (CT-IGRT) may be beneficial to decrease dose to organs at risk (OARs), when treating the stomach with radiotherapy for lymphoma. We compared dosimetric parameters of OARs from plans generated using free-breathing (FB) versus DIBH for 10 patients with non-Hodgkin lymphoma involving the stomach treated with involved site radiotherapy. All patients had 4DCT and DIBH scans. Planning was performed with intensity modulated radiotherapy (IMRT) to 30.6 Gy in 17 fractions. Differences in target volume and dosimetric parameters were assessed using a paired two-sided t-test. All heart and left ventricle parameters including mean dose, V30, V20, V10, and V5 were statistically significantly lower with DIBH. For IMRT-FB plans the average mean heart dose was 4.9 Gy compared to 2.6 Gy for the IMRT-DIBH group (p < 0.001). There was a statistically significant decrease in right kidney dose with DIBH. For lymphoma patients treated to the stomach with IMRT, DIBH provides superior OAR sparing compared to FB-based planning, most notably reducing dose to the heart and left ventricle. This strategy could be considered when treating other gastric malignancies.

KW - Deep inspiration breath-hold

KW - Gastric lymphoma

KW - Heart dose

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JO - Clinical and Translational Radiation Oncology

JF - Clinical and Translational Radiation Oncology

ER -

Decreased heart dose with deep inspiration breath hold for the treatment of gastric lymphoma with IMRT

Abstract

Keywords

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